tbuckley/cabot-search huggingface dataset:
Novel clip–traction band device-assisted endoscopic submucosal dissection for superficial pharyngeal carcinoma
Authors: Tomoaki Tashima, Takahiro Muramatsu, Tsubasa Ishikawa, Tomonori Kawasaki, Akashi Fujita, Yuki Tanisaka, Shomei Ryozawa
Journal: Endoscopy (2023)

Extracorporeal traction-assisted endoscopic submucosal dissection (ESD) for superficial pharyngeal carcinoma has been useful [1] [2] [3]. However, owing to the anatomical features of the larynx and thyroid cartilage, working spaces within the pharynx are narrow. Furthermore, instruments such as intubation tubes, laryngoscopes, grasping forceps [1], and thin endoscopes [2] for traction of the lesion interfere with the endoscope, making endoscopic maneuverability difficult. Methods to overcome such difficulties have been reported in recent years [4] [5].
Sequential oral antibiotic in uncomplicated Staphylococcus aureus bacteraemia: a propensity-matched cohort analysis
Authors: Itziar Diego-Yagüe, Alberto Mora-Vargas, Jose Manuel Vázquez-Comendador, Beatriz Santamarina-Alcantud, Ana Fernández-Cruz, Elena Múñez-Rubio, Andrea Gutiérrez-Villanueva, Isabel Sanchez-Romero, Victor Moreno-Torres, Antonio Ramos-Martínez, Jorge Calderón-Parra
Journal: Clinical Microbiology and Infection (2023)
A Novel Radiogenomics Biomarker for Predicting Treatment Response and Pneumotoxicity From Programmed Cell Death Protein or Ligand-1 Inhibition Immunotherapy in NSCLC
Authors: Mitchell Chen, Haonan Lu, Susan J. Copley, Yidong Han, Andrew Logan, Patrizia Viola, Alessio Cortellini, David J. Pinato, Danielle Power, Eric O. Aboagye
Journal: Journal of Thoracic Oncology (2023)

IntroductionPatient selection for checkpoint inhibitor immunotherapy is currently guided by programmed death-ligand 1 (PD-L1) expression obtained from immunohistochemical staining of tumor tissue samples. This approach is susceptible to limitations resulting from the dynamic and heterogeneous nature of cancer cells and the invasiveness of the tissue sampling procedure. To address these challenges, we developed a novel computed tomography (CT) radiomic-based signature for predicting disease response in patients with NSCLC undergoing programmed cell death protein 1 (PD-1) or PD-L1 checkpoint inhibitor immunotherapy.MethodsThis retrospective study comprises a total of 194 patients with suitable CT scans out of 340. Using the radiomic features computed from segmented tumors on a discovery set of 85 contrast-enhanced chest CTs of patients diagnosed with having NSCLC and their CD274 count, RNA expression of the protein-encoding gene for PD-L1, as the response vector, we developed a composite radiomic signature, lung cancer immunotherapy—radiomics prediction vector (LCI-RPV). This was validated in two independent testing cohorts of 66 and 43 patients with NSCLC treated with PD-1 or PD-L1 inhibition immunotherapy, respectively.ResultsLCI-RPV predicted PD-L1 positivity in both NSCLC testing cohorts (area under the curve [AUC] = 0.70, 95% confidence interval [CI]: 0.57–0.84 and AUC = 0.70, 95% CI: 0.46–0.94). In one cohort, it also demonstrated good prediction of cases with high PD-L1 expression exceeding key treatment thresholds (>50%: AUC = 0.72, 95% CI: 0.59–0.85 and >90%: AUC = 0.66, 95% CI: 0.45–0.88), the tumor's objective response to treatment at 3 months (AUC = 0.68, 95% CI: 0.52–0.85), and pneumonitis occurrence (AUC = 0.64, 95% CI: 0.48–0.80). LCI-RPV achieved statistically significant stratification of the patients into a high- and low-risk survival group (hazard ratio = 2.26, 95% CI: 1.21–4.24, p = 0.011 and hazard ratio = 2.45, 95% CI: 1.07–5.65, p = 0.035).ConclusionsA CT radiomics-based signature developed from response vector CD274 can aid in evaluating patients' suitability for PD-1 or PD-L1 checkpoint inhibitor immunotherapy in NSCLC.
Tenecteplase versus alteplase in acute ischaemic cerebrovascular events (TRACE-2): a phase 3, multicentre, open-label, randomised controlled, non-inferiority trial
Authors: Yongjun Wang, Shuya Li, Yuesong Pan, Hao Li, Mark W Parsons, Bruce C V Campbell, Lee H Schwamm, Marc Fisher, Fengyuan Che, Hongguo Dai, Deyang Li, Runhui Li, Junhai Wang, Yilong Wang, Xingquan Zhao, Zixiao Li, Huaguang Zheng, Yunyun Xiong, Xia Meng, Runhui Li, Dong Wang, Yongjun Wang, Shengli Chen, Dan Deng, Hong Zhang, Junhai Wang, Huisheng Chen, Hongwei Zhang, Yiping Wu, Hong Liu, Guozhi Lu, Liandong Zhao, Runxiu Zhu, Ying Liu, Fei Yi, Jianhua Gao, Hongguo Dai, Junfang Hao, Fengyuan Che, Xueli Cai, Zhihui Duan, Hong Yu, Tongguo Wei, Yufeng Tang, Zhaolong Peng, Baochao Zhang, Yan Song, Xiaofei Chen, Yunlin Liu, Jing Liu, Deyang Li, Weili Zhao, Xiue Wei, Qian Xue, Xuewen Liu, Yi Yang, Chuansheng zhao, Jun Chen, Yi Sui, Guizhi Sheng, Yun Zhang, Junyan Liu, Lianhuan Zhang, Weiwei Wang, Zhiyong Guo, Hao Li, Renping Hu, Guofang Chen, Zhigang Liang, Junbin Chen, Lei Xia, Zhihua Long
Journal: The Lancet (2023)
A Legacy of Osler
Authors: Mark Siegler
Journal: JAMA (1978)

The teaching of clinical medicine at the bedside is an enduring legacy of the Oslerian revolution in American education. The advantages of teaching clinical ethics at the bedside include dealing with actual cases to maximize personal accountability, reinforcing the relationship between technical competence and ethical decisions, involving the entire health care team, and possibly decreasing the resistance of the medical profession to formal medical ethics. The proposal to teach clinical ethics at the bedside is intended to indicate a primary role for ethicists and clinicians at different stages in the medical curriculum. During the preclinical years of medical school, ethicist-philosophers, assisted by clinicians, should assume primary responsibility for teaching medical ethics. During the clinical years, physicians, assisted by clinically informed ethicist-philosophers, should accept the primary obligation to teach clinical ethics at the bedside. (<i>JAMA</i>239:951-956, 1978)
Hepatitis B virus persistence after recovery from acute viral hepatitis.
Authors: T I Michalak, C Pasquinelli, S Guilhot, F V Chisari
Journal: Journal of Clinical Investigation (1994)

Contrary to current opinion, the disappearance of hepatitis B surface antigen (HBsAg) from the serum, the development of anti-HBs antibodies, and normalization of liver function may not reflect complete virological recovery from acute hepatitis B virus (HBV) infection. By using the polymerase chain reaction (PCR), in the current study we demonstrate long-term persistence of HBV DNA in the serum and peripheral blood mononuclear cells (PBMC) of four patients for up to 70 mo after complete clinical, biochemical, and serological recovery from acute viral hepatitis. Serum HBV DNA reactivity co-sedimented with HBsAg in sucrose gradients, and it displayed the size and density characteristics of naked core particles and intact HBV virions, presumably contained within circulating immune complexes in these anti-HBs antibody-positive sera. HBV DNA was also present in PBMC in late convalescent samples from all four patients, and HBV RNA was detected in late convalescent phase PBMC in two of these patients. These results suggest that HBV DNA, and possibly HBV virions, can be present in the serum, and that the viral genome can persist in a transcriptionally active form in PBMC for > 5 yr after complete clinical and serological recovery from acute viral hepatitis.
Development of Allergic Nickel Dermatitis From Earrings
Authors: L. Edward Gaul
Journal: JAMA (1967)

WEARING EARRINGS is the latest vogue among adolescent girls. The most fashionable earrings require the ear lobes to be pierced. A physician may do this, a friend, or a relative; it is possible to buy an instrument to do it yourself; and there is even a gadget available that will pierce the ears while sleeping. It is common practice to insert the jewelry device at once so that the channel stays open. During the fall of 1966 and in a period of one month, five girls were seen with itchy, inflamed, and indurated ear lobes. Brief reports of the cases are presented. <h3>Report of Cases</h3><h3>Case 1.—</h3> A apprehensive 19-year-old girl was seen for a papular acne. Her inflamed ear lobes drew attention. In July, 1966, the girl's grandmother had pierced her ears with a heated needle. A set of 10-carat gold, post-type earrings were inserted and worn daily. Inflammation
Calcium supplementation of the diet--II.
Authors: J. A. Kanis, R. Passmore
Journal: BMJ (1989)

ReviewCalcium supplementation of the diet-II Notjustified by present evidence Last week we looked at the way diverging views on the role of calcium had arisen.This week we conclude our re-examination of the evidence with a look at the part calcium plays in the menopause, in the elderly, and in fractures.
Nonhemorrhagic Decrements in Hematocrit Values After Percutaneous Renal Biopsy
Authors: W. Kline Bolton
Journal: JAMA (1977)

Seventy patients without bleeding after a percutaneous renal biopsy (PCB) were studied to define the incidence of decrements in hematocrit values, hypotension, and bradycardia. Hematocrit values decreased 0.5% in 60% of the patients, ≥1% in 44%, and ≥2% in 34% of patients. After PCB, an increase of ≥1% occurred in 55% of the patients with hematocrit nadirs of ≥1%. Hematocrit values increased 3.0%±0.6% in 8/19 patients with a previous decrease of ≥2% but continued to decrease in 13% of the patients. A weight gain or positive fluid balance occurred in 29%, hypotension in 7%, and relative bradycardia in 4% of the patients. These studies show that a decrease in hematocrit values and hypotension may occur in patients after PCB without bleeding. This may result from hemodilution and increased parasympathetic discharge and as part of a natural spectrum of decreasing hematocrit levels coincident with PCB. (<i>JAMA</i>238:1266-1268, 1977)
Hypokalemic Rhabdomyolysis and Acute Renal Failure
Authors: Scott M. Nadel
Journal: JAMA (1979)

A patient experienced severe hypokalemia in the setting of prolonged nasogastric suction and total parenteral nutrition. Severe rhabdomyolysis and acute renal failure ensued. Review of the literature failed to disclose a similar case of hypokalemic rhabdomyolysis and acute renal failure, although the syndrome has been associated with other causes of hypokalemia, and its pathophysiology has been investigated in experimental models. The morbidity associated with extensive myonecrosis and severe, acute renal failure in this patient indicates that hypokalemia and other electrolyte abnormalities should be aggressively corrected in similar clinical settings. (<i>JAMA</i>241:2294-2296, 1979)
Extended Radical Mastectomy
Authors: Everett D. Sugarbaker
Journal: JAMA (1964)

Results of 156 extended radical mastectomies on 151 patients, which included removal of the homolateral internal mammary node chain, are compared very favorably with results of 97 conventional mastectomies on 94 patients. All operations were done by the same surgeon, on consecutive patients, under uniform conditions. Extent of disease, as measured by axillary lymph node involvement, was essentially the same in both groups. There were no postoperative deaths. The five-year survival rate for patients having the conventional operation was 57% compared to 70% for those operated on during the era of the extended operation. On the basis of these findings, removal of the internal mammary lymph nodes as part of the radical mastectomy is strongly recommended.
Acquired Immunodeficiency Syndrome in New York City
Authors: Mary E. Chamberland
Journal: JAMA (1985)

In January 1983, the New York City Department of Health initiated an active surveillance program for acquired immunodeficiency syndrome (AIDS) in 19 hospitals and a modified-active surveillance program in the remaining 69 hospitals. We reviewed hospital laboratory and autopsy records in 12 active surveillance hospitals and three modified-active surveillance hospitals six months later. Patients who had opportunistic diseases characteristic of AIDS diagnosed in 1982 (before active surveillance) and 1983 (after implementation of active surveillance) were matched against health department AIDS surveillance reports. For the 16 months we evaluated, 96% of patients identified with AIDS in the 12 active surveillance hospitals and 100% of those in the three modified-active surveillance hospitals had been reported to the health department. The delay between diagnosing a case and reporting it to the health department significantly decreased between 1981 and the first six months of 1983 in all hospitals. The proportion of cases reported within one month of diagnosis increased from 45% to 69% during this period. We conclude that the current surveillance program for AIDS in New York City is effective and that case reporting is sufficiently complete for accurate analysis of disease trends. (<i>JAMA</i>1985;254:383-387)
Ureteral Injuries During Surgery
Authors: Charles C. Higgins
Journal: JAMA (1967)

Ureteral injuries during the course of surgical procedures within the pelvis occur more frequently than presumed. A series of 87 patients with ureteral injuries is reviewed from the standpoint of pathogenesis, diagnosis, treatment, end results, and prophylaxis. The ideal time for the repair of the injured ureter is at the time of operation or early in the period of convalescence. The procedure of choice is end-to-end anastomosis of the severed spatulated ends of the ureter. When this cannot be accomplished, reimplantation of the ureter into the bladder is recommended. Ligation of the proximal severed end of the ureter is rarely indicated, as a surgical procedure is now available that usually spares the kidney. Preoperative insertion of ureteral catheters as a precaution against ureteral injury is of questionable value.
Occupational Solvent Exposure and Glomerulonephritis
Authors: William E. Daniell
Journal: JAMA (1988)

We describe a patient who presented with renal failure after a one-year period of unprotected heavy occupational exposure to organic solvents. Renal biopsy results and serological findings were diagnostic of anti—glomerular basement membrane antibody—mediated glomerulonephritis. An analytic review of the literature revealed substantial evidence linking solvent exposure to the development of glomerulonephritis (GN), with seven of nine case-control studies demonstrating a statistically significant association. Odds ratios were reported by or could be calculated for six of these studies, and the five positive studies detected a 2.8- to 8.9-fold increased risk for GN among solvent-exposed individuals. The findings in several of these studies of dose-response relationships, the reports of variations in disease severity in relation to exposure intensity, and the absence of alternative explanations for the association provide additional supportive evidence for a solvent effect. In the majority of cases of anti—glomerular basement membrane antibody—mediated GN and other types of GN, there is no remarkable preceding exposure to organic solvents. However, we conclude that in the case presented herein and in cases of GN with similar exposure histories, solvent exposure may play a significant contributing role in the development of GN. (<i>JAMA</i>1988;259:2280-2283)
In the Matter of Witch Hunts
Authors: June E. Osborn
Journal: JAMA (1978)

REMEMBER the days of the early 1950s? Accusations, congressional investigations, and imputed guilt could all be coalesced by the simple tactic of repetitious statements of purported wrongdoing. Professionals of extraordinary quality were brought down, and some say that whole agencies of the government never recovered from the loss of invaluable talent that resulted. That era was not the first in which such tactics had proved effective and, sadly, it was not the last. I think we are currently observing a kind of biomedical McCarthyism, which, if unchecked, can leave a gaping hole where strong, scientifically based regulation of biologics used to be. The Bureau of Biologics of the Food and Drug Administration is an excellent agency of government that is under siege from a small cadre of strident critics. There is room for grave concern that their sustained attack might soon exceed the patience of the talented group of scientists
Cancer of the Female Urethra
Authors: Harry Grabstald
Journal: JAMA (1966)

Experience with 79 women with cancer of the urethra suggests that the occurrence of regional-lymph-node and distant metastases is sufficiently low to make probable a relatively high cure rate if the primary tumor is successfully treated. Partial urethrectomy is usually successful in controlling lesions limited to the anterior part of the urethra and equally satisfactory results may be achievable with modern methods of irradiation. For lesions involving the entire urethra, prognosis with either radiation therapy or radical surgery has been poor, but it is possible that improved techniques of irradiation, either alone or in combination with radical surgery, may improve survival. Survival is determined chiefly by the extent of the neoplasm at the time of treatment, thus emphasizing the importance of earlier recognition of these tumors.
Humanitarian issues
Authors: J. Nicholson, N. Gerrard, E. Harris, W J. Appleyard, D. Southall, C. Shepherd
Journal: BMJ (1998)

Monoclonality of mammalian cell lines used for production of biologics is a regulatory expectation and one of the attributes assessed as part of a larger process to ensure consistent quality of the biologic. Historically, monoclonality has been demonstrated through statistics generated from limiting dilution cloning or through verified flow cytometry methods. A variety of new technologies are now on the market with the potential to offer more efficient and robust approaches to generating and documenting a clonal cell line. Here we present an industry perspective on approaches for the application of imaging and integration of that information into a regulatory submission to support a monoclonality claim. These approaches represent the views of a consortium of companies within the BioPhorum Development Group and include case studies utilising imaging technology that apply scientifically sound approaches and efforts in demonstrating monoclonality. By highlighting both the utility of these alternative approaches and the advantages they bring over the traditional methods, as well as their adoption by industry leaders, we hope to encourage acceptance of their use within the biologics cell line development space and provide guidance for regulatory submission using these alternative approaches. <i>LAY ABSTRACT:</i> In the manufacture of biologics produced in mammalian cells, one recommendation by regulatory agencies to help ensure product consistency, safety, and efficacy is to produce the material from a monoclonal cell line derived from a single, progenitor cell. The process by which monoclonality is assured can be supplemented with single-well plate images of the progenitor cell. Here we highlight the utility of that imaging technology, describe approaches to verify the validity of those images, and discuss how to analyze that information to support a biologic filing application. This approach serves as an industry perspective to increased regulatory interest within the scope of monoclonality for mammalian cell culture–derived biologics.
Pharmacologic Suppression of the Fetal Adrenal Gland In Utero
Authors: Mark I. Evans
Journal: JAMA (1985)

21-Hydroxylase deficiency results in congenital adrenal hyperplasia and leads to masculinization of the external genitalia of affected females. This complication could be avoided if fetal adrenal gland function were suppressed. A woman with mild 21-hydroxylase deficiency whose previous female child had classic congenital adrenal hyperplasia with masculinization was given dexamethasone beginning at the tenth week of gestation. Maternal estriol and cortisol values indicated rapid and sustained fetal and maternal adrenal gland suppression. At 39 weeks' gestation, the patient was spontaneously delivered of a female neonate with normal external genitalia. Postnatal tests indicated the infant was a single heterozygote for 21-hydroxylase deficiency. This study demonstrates prolonged suppression of the fetal adrenal gland with dexamethasone and suggests it might prevent abnormal masculinization in fetuses with severe congenital adrenal hyperplasia. (<i>JAMA</i>1985;253:1015-1020)
Microcytosis
Authors: M. H. Steinberg
Journal: JAMA (1983)

Smaller-than-normal RBCs (microcytosis) are commonly detected as a by-product of RBC counts measured by electronic particle counters. Their presence provides a clue to the existence of iron deficiency, thalassemia, and other less common disorders. The differential diagnosis of microcytosis is discussed, an approach to its evaluation is outlined, and illustrative cases that typify several causes of microcytosis are presented. (<i>JAMA</i>1983;249:85-87)
Recurrences and Sequelae of Rheumatic Fever in Nashville
Authors: Robert W. Quinn
Journal: JAMA (1977)

A follow-up study of 311 patients who acquired rheumatic fever in Nashville, Tenn, during the period from 1963 to 1969 showed that 53% took penicillin prophylaxis regularly, 36% did not take it as recommended, and 11% did not take it at all. There were no recurrences among those who received prophylaxis by injection regularly, six recurrences among those who took oral prophylaxis regularly, and no recurrences among 45 subjects who did not take prophylaxis. Among these 45, however, were 29 for whom prophylaxis was not recommended by their physicians. The original study indicated that the incidence of acute rheumatic fever among blacks was twice as high as among whites. In the present study, incidence of rheumatic heart disease and recurrences was substantially higher among blacks than among whites. (<i>JAMA</i>238:1512-1515, 1977)
Circadian changes in anticoagulant effect of heparin infused at a constant rate.
Authors: H A Decousus, M Croze, F A Levi, J G Jaubert, B M Perpoint, J F De Bonadona, A Reinberg, P M Queneau
Journal: BMJ (1985)

Six patients with venous thromboembolism were treated with heparin, administered intravenously by a constant infusion pump. The initial daily dose of heparin was adjusted to keep the activated partial thromboplastin time, sampled at 0800, between 1.5 and 2.5 times the control level. Once that level was obtained, this dose was kept constant. Anticoagulation was thereafter measured, every four hours for 48 hours, by activated partial thromboplastin time, thrombin time, and coagulation factor Xa inhibition assay. The results of all three coagulation tests showed a circadian variation in the six patients. Maximum values were achieved at night and minimum values in the morning. These circadian variations were reproduced for two consecutive days. Differences between night and morning values reached almost 50% for activated partial thromboplastin time, 60% for thrombin time, and 40% for factor Xa inhibition assay. This circadian variation resulted from two rhythms, a circadian rhythm lasting 24 hours and an ultradian rhythm lasting 12 hours, which were detected by cosinor analysis for each coagulation test (p less than 0.01). A circadian rhythm was detected individually in most of the patients for each coagulation test (p less than 0.05). All patients had a nocturnal peak in activated partial thromboplastin time on both days. In four patients this peak exceeded the upper desired limit of activated partial thromboplastin time. These rhythms should be taken into account when evaluating the dosage of heparin to be administered.